La Franca Lamberto, Alkabes Micol, Muraca Andrea, La Franca Lamberto, Rabiolo Alessandro, Fogagnolo Paolo, Ranno Stefano, Frerio Filippo, Marchetti Mattia, Wild Davide, Gatti Valentina, De Cillà Stefano
Department of Ophthalmology, University Hospital Maggiore della Carità, Novara, Italy.
Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Ophthalmologica. 2025;248(4):239-248. doi: 10.1159/000546248. Epub 2025 May 3.
Epiretinal membrane (ERM) is a condition that can lead to visual impairment and metamorphopsia. This study aimed to examine the correlation between metamorphopsia and foveal microstructure before and after macular surgery in a cohort of patients with advanced ERM.
The severity of metamorphopsia was quantified using M-CHARTS, and foveal microstructure was evaluated via two optical coherence tomography (OCT) measures: central foveal thickness and ectopic inner foveal layer (EIFL). Assessments were performed pre- and post-surgery with an average follow-up of 1 year. Correlations between morphological and functional parameters pre- and post-surgery were explored by means of regression analysis.
Sixty eyes of 57 patients diagnosed with advanced ERM and surgically treated were included in the study. Our findings showed a significant correlation between postoperative metamorphopsia and both pre- (R2 = 0.431) and postoperative (R2 = 0.300) EIFL thickness. Disparities were observed in metamorphopsia scores between patients with ERM stages 3 and 4, both pre- (0.46 ± 0.31 and 0.84 ± 0.32, respectively, p < 0.01) and post-surgery (0.18 ± 0.21 and 0.46 ± 0.28, respectively, p < 0.01). Postoperative EIFL thickness was the only variable significantly associated with postoperative metamorphopsia scores according to multiple regression analysis.
EIFL thickness emerges as a critical determinant of postoperative metamorphopsia severity, underscoring its importance in predicting functional outcomes after ERM surgery. Although surgery improved metamorphopsia across stages, patients with more advanced ERM experienced less favorable outcomes, stressing the importance of a timely surgical intervention.
视网膜前膜（ERM）是一种可导致视力损害和视物变形的病症。本研究旨在探讨一组晚期ERM患者黄斑手术后视物变形与黄斑中心凹微结构之间的相关性。
使用M-CHARTS对视物变形的严重程度进行量化，并通过两种光学相干断层扫描（OCT）测量方法评估黄斑中心凹微结构：中心凹厚度和异位的中心凹内层（EIFL）。在手术前后进行评估，平均随访1年。通过回归分析探讨手术前后形态学和功能参数之间的相关性。
本研究纳入了57例诊断为晚期ERM并接受手术治疗患者的60只眼。我们的研究结果显示，术后视物变形与术前（R2 = 0.431）和术后（R2 = 0.300）EIFL厚度均显著相关。在ERM 3期和4期患者之间，术前（分别为0.46±0.31和0.84±0.32，p < 0.01）和术后（分别为0.18±0.21和0.46±0.28，p < 0.01）的视物变形评分存在差异。根据多元回归分析，术后EIFL厚度是与术后视物变形评分唯一显著相关的变量。
EIFL厚度是术后视物变形严重程度的关键决定因素，突显了其在预测ERM手术后功能结局中的重要性。尽管手术改善了各阶段的视物变形，但ERM程度越严重的患者预后越差，强调了及时进行手术干预的重要性。
